This proposal seeks support for an expanded collaboration between scientists in Lao National Committee for the Control of AIDS of the Ministry of Health, The Lao Red Cross Blood Center and faculty from Chiang Mai University, Thailand, the Thai Ministry of Public Health, and the Johns Hopkins University, Schools of Medicine and Public Health in training and research to improve blood safety in Laos. Laos is one of the world's ten poorest nations, and regular screening of blood for several pathogens, including HIV, is not yet available or practiced nationwide; two of the nation's fifteen provinces are currently only screening blood with malaria thick films. In contrast, Thailand has more than a decade of experience in blood safety in the context of a severe epidemic of HIV, and Chiang Mai University's Blood Bank is a regional model. The goals of this program are to strengthen blood safety programs in Laos through training Lao scientists in blood products screening, donor deferral, proper use of blood and blood products, and improved Fellows would be trained in Laos, at Chiang Mai University in Thailand, and, where appropriate, at John Hopkins University. Since the least-developed component of blood safety in Laos is at the provincial and district levels, and virtually all staff at those levels speaks only Lao (a cognate language to Thai), the bulk of in-country training activities will be in Lao and Thai. We have successfully completed two years of Fogarty AITRP Thai-Lao collaborative training in HIV/AIDS prevention research using this model, and it has proven cost-effective, and allowed Lao physicians and public health staff to receive high quality training (up to MHS level) in their language and region. Specifically, we propose a three year program. The first year would include: One in-country training workshop for blood banking staff from all of Laos' Provinces, with faculty from Thailand and the John Hopkins; two Lao senior scientists would receive short-term laboratory training in the Johns Hopkins Hospital Blood Bank (Director, Dr. P. Ness); four Lao scientists from targeted provincial program would be trained in Thailand; and 8-10 provincial staff would receive intensive training in Laos with Thai faculty. The second year would include: one Advanced Research Training (ART) award for a Lao scientist in improved blood screening using a pooled sera approach; two Lao Scientists to train in JHU in reducing unnecessary use of blood products and in behavioral aspects of donor deferral research; and 5 Lao scientists would be trained at Chiang Mai University in laboratory, clinical, and management aspects of improving blood safety. The third year would focus on in-country research for fellows trained in years one and two, and would include three ART awards, with mentoring from JHU and Thai faculty. One of these awards will focus on the establishment of donor and recipient registries, one on development of strategies to increase donations low risk donors in rural areas in Laos, and one on the potential use of autologous donation to improve blood safety.